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Coronavirus Pandemic: Coping with the Psychological Outcomes, Mental

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DOI: 10.36811/ojda.2020.110005

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 Coronavirus Pandemic: Coping with the Psychological Outcomes,
Mental Changes, and the “New Normal” During and After COVID-19
DOI: https://doi.org/10.36811/ojda.2020.110005 OJDA: June-2020: Page No: 07-19

Open Journal of Depression and Anxiety

Review Article Open Access
Coronavirus Pandemic: Coping with the Psychological Outcomes, Mental
Changes, and the “New Normal” During and After COVID-19
Hiba Takieddine1, Samaa AL Tabbah2*
1
Clinical Psychologist, Lebanese University, Psychology Department, Beirut, Lebanon
2
Clinical Pharmacist, Lebanese American University, School of Pharmacy, Beirut, Lebanon

*Corresponding Author: Samaa Al Tabbah, Lebanese American University, School of Pharmacy,

Beirut, Lebanon, Email: Samaa.tab@hotmail.com

Received Date: May 19, 2019 / Accepted Date: May 21, 2019/ Published Date: Jun 01, 2020
Abstract
Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has rapidly swept across the
world, inducing a considerable degree of fear, worry and concern in the population at large and among
certain groups in particular, such as older adults, healthcare providers and people with underlying health
conditions. Authorities around the world tried to prevent the virus spread by imposing social distancing
measures, quarantining citizens and isolating infected persons. Apart from its physical impact, COVID-
19 pandemic has brought numerous changes to people’s lives. It changed daily routines, caused
worldwide economic crisis, increased unemployment, and placed people under emotional and financial
pressures. It affected people psychologically and mentally especially in terms of emotions and
cognition. During the acute crisis, everyone to varying degrees experienced fear of infection, somatic
concerns, worries about the pandemic’s consequences, loneliness, depression, stress, as well as
increased alcohol and drug use. As part of its public health response, the World Health Organization
(WHO) has worked with partners to develop a set of new guidelines and messages that can be used to
prevent, manage, and support mental and psychological well-being in different vulnerable target groups
during the outbreak. Whether people like it or not, the psychological sequela of this pandemic will
emerge and persist for months and years to come leading to long-term consequences. New lifestyles
and “New Normals” will surely emerge. The main purpose of this review is to summarize the impact
of coronavirus pandemic on the psychological and mental health of people around the world especially
vulnerable groups. It also presents the relevant intervention actions and recommendations to cope
efficiently and effectively with the psychological short-term and long-term outcomes, mental changes,
and the “New Normal” during and after COVID-19.
Keywords: COVID-19; Coronavirus, Psychological; Mental; New Normal

Cite this article as: Hiba Takieddine, Samaa AL Tabbah. 2020. Coronavirus Pandemic: Coping with
the Psychological Outcomes, Mental Changes, and the “New Normal” During and After COVID-19.
Open J Depress Anxiety. 2: 07-19.

Copyright: This is an open-access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are credited. Copyright © 2020; Hiba Takieddine

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 Coronavirus Pandemic: Coping with the Psychological Outcomes,
Mental Changes, and the “New Normal” During and After COVID-19
DOI: https://doi.org/10.36811/ojda.2020.110005
Introduction
Coronavirus disease 2019 (COVID-19) is a
highly infectious disease caused by Sars-Cov-
2 (Severe Acute Respiratory Syndrome
Coronavirus 2) [1]. Since its emergence in
China, the virus has spread to every continent
of the world [2]. The World Health
Organization (WHO) has identified it as a
pandemic and a public health emergency of
major international concern [3,4]. The virus
spreads mainly among people through close
contact, often via small droplets produced
during coughing, sneezing, talking or
touching a contaminated surface [5-7].
Countries raced to stop the virus spread
through testing and treating patients, carrying
out contact tracing, recommending hand
washing, and enforcing the use of Personal
Protective Equipment (PPE) [8-10]. In
addition, authorities around the world tried to
prevent the virus spread by imposing social
distancing measures such as restricting travel,
canceling large gatherings like sports events,
concerts and schools, quarantining citizens
and isolating suspected infected persons
[11,12]. Dozens of cities around the world
were deserted as people stayed indoors, either
by choice or by quarantine imposed by their
governments [13]. Apart from its physical
impact, the COVID-19 pandemic has brought
numerous changes to people’s lives. This
quarantine and social isolation, changed daily
routines, caused economic crisis, increased
unemployment, and placed people under
emotional and financial pressures [14]. The
uncertainty and low predictability of COVID-
19 affected people psychologically and
mentally especially in terms of emotions and
cognition. People were concerned about getting
sick, how long the pandemic will last, and what
the future will bring [15]. In addition,
information overload, rumors and
misinformation made their lives feel
uncontrollable and they had no idea what to do
[16,17]. A recent study by medical journal
“The Lancet” notes that the psychological
impact of quarantine can be great, leading to a
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range of mental health concerns from anxiety
and anger to sleep disturbances, depression and
post-traumatic stress disorder (PTSD). Weeks
of self-isolation with signs that the coronavirus
pandemic is not going to end soon brings the
most optimistic person near pessimism
wondering just how long will this last [18].
Understanding the psychological and mental
health response after a public health emergency
could guide authorities, healthcare
professionals, and communities in helping
populations to cope with current disasters and
be prepared for new ones [14,15]. The main
purpose of this review is to summarize the
impact of coronavirus pandemic on the
psychological and mental health of people
around the world especially vulnerable groups.
It also presents the relevant intervention actions
and recommendations to cope efficiently and
effectively with the psychological short-term
and long-term outcomes, mental changes, and
the “New Normal” during and after COVID-19.
Psychological and Mental Health
Changes During COVID-19 Pandemic
In response to the accelerating COVID-19
pandemic, increasingly stringent measures are
put in place to slow the spread of coronavirus
by keeping people apart, banning all non-
essential activities and asking residents to stay
at home [19]. Worldwide, colleges and offices
have gone entirely online, schools and
restaurants have closed down, and nursing
homes have stopped accepting visitors [12].
In light of these devastating changes, people are
facing three immediate responses [20,21]:
,
1. Health response: by adhering to the health
guidelines to combat the virus.
2. Survival response: by trying to maintain
food supplies and essential health products.
3. Economic response: by struggling to keep
up with what is left from their finances
where most of them have lost their main
source of income as well as most of their
savings as a result of the economic crisis.
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 Coronavirus Pandemic: Coping with the Psychological Outcomes,
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DOI: https://doi.org/10.36811/ojda.2020.110005
The effects of these responses can translate
into a range of individual emotional
reactions (e.g., insecurity, confusion,
distress or psychiatric conditions,
emotional isolation, and stigma) that are
then echoed by communities (because of
work and school closures, economic loss,
inadequate medical resources, and poor
distribution of necessities) [22-24].
Mental health concerns could be exacerbated by
quarantine-related stressors such as fear of
infection, boredom, frustration, inadequate
supplies, lack of information, financial loss, and
stigma associated with contracting the disease.
In addition to that, long-term quarantine or
complete social isolation (without existing
compensatory methods) could aggravate
anxiety, depression and a sense helplessness
[18,25]. Moreover, COVID-19 can cause
psychological responses such as increased
worry about children being at home alone
(during school shutdowns etc.) while parents
have to be at work and risk of deterioration of
physical and mental health of vulnerable
individuals if care support is not in place [26].
Types of Reactions to the COVID-19
Crisis
In addition to the stresses inherent in the disease
itself, mass-home containment directives
(including home-stay orders, quarantine and
isolation) raise concerns about how people will
react individually and collectively.
Approximately, there are four types of people’s
reactions to the COVID-19 crisis and the
conditional social isolation [27]:
1. Some people take it all step by step relying
on a foundation of psychic stability.
2. Others are the worried ones who need only
some first aid psychologically.
3. A third group which has not experienced
these psychologic disorders before and now
are thrown into them.
4. Lastly, many who have already had major
depressive disorders may have their
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conditions exacerbated, developing what
clinicians call "double depression," where a
persistent depressive disorder is overlaid
with an episode of psychological pain.
Most Susceptible Groups to the Adverse
Psychological and Mental Effects of
COVID-19
According to the Centers for Disease Control
and Prevention (CDC), some groups may be
more susceptible to coronavirus psychological
and mental effects than others, and they may
respond more strongly to the stress of this crisis,
in particular [28,29]:
1. Infected people: Infected people in
isolation may experience boredom, anger,
and loneliness. Moreover, the symptoms of
the viral infection such as cough and fever
may also cause psychological and mental
distress and anxiety among this group [30].
2. People who live in nursing homes or
long-term care facilities: The common
characteristic of nursing homes and long-
term care facilities, and the type of
population served (generally older adults
often with underlying medical conditions),
put those living in nursing homes at a
higher risk of infection and serious
psychological and mental illness from
COVID-19 [31].
3. Elderly people: Although COVID-19 can
affect any group, the older a person is, the
greater the risk of serious illness. Older
adult immune systems get weaker with age,
making it more difficult to fight off
infections. Moreover, older adults
commonly suffer from chronic diseases that
may increase the risk of severe illness from
COVID-19. Due to this situation, elderly
people may suffer from psychological and
mental health problems such as stress,
anxiety, depressive symptoms, insomnia,
denial, anger, and fear [32].
4. People with chronic diseases: People with
chronic diseases like asthma, chronic lung
disease, diabetes, heart conditions, and
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chronic kidney disease have reduced ability
to fight infections, including viruses like
COVID-19. Moreover, there is huge
concern that if these patients get infected,
they may remain infectious for longer than
other COVID-19 patients. This situation
may increase the fear among this group and
thus lead to further psychological and
mental complications [31].
5. Immunocompromised people: People
with weakened immune systems have less
ability to fight infectious diseases,
including viruses such as coronavirus.
There is great fear and worry among this
group that they are more susceptible to
coronavirus infection which may lead to
death. This fear puts them, under huge
pressure and stress and may lead to mental
health deterioration and psychological
distress [31].
6. People with preexisting psychiatric, or
substance use problems: A rapidly
moving disease can aggravate the
challenges for anyone with a preexisting
mental health condition or a problem with
substance abuse. People in this group are
hit harder, coronavirus is a double crisis,
and the present moment is one of
intensified distress [33].
7. Health care providers: This group is
particularly vulnerable to emotional
distress in the current pandemic, given their
risk of virus exposure and infection,
concern about infecting their loved ones,
shortage of personal protective equipment
(PPE), exhaustion due to longer working
hours, and involvement in resource
allocation decisions that are ethically and
emotionally draining [27,34,35].
Signs of Psychological and Mental
Health Changes During COVID-19
According to the American Psychological
Association (APA), there’s a spectrum or a
range of emotions people are expected to have
during this coronavirus pandemic. In addition,
the CDC notes that people should look within
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themselves and others for signs of distressed
psychological and mental health in order to
distinguish between ordinary fear and the
beginnings of a breakdown. Signs and
symptoms may include [36,37]:
1. Fear and anxiety: It is normal to be
worried about contracting or spreading
COVID-19. The virus is highly contagious,
people are concerned and worried about
their own health, worried about falling ill
and dying, and worried about losing people
they love. All of these feelings lead to fear
and anxiety. Moreover, people are worried
about unpredictable shortages in food
supplies, medications, and regular medical
care or community services that may be
disrupted by the closure of facilities and
public transport [38].
2. Depression and boredom: During a lock-
down period, the normal daily routines are
completely empty. People stay at home
rather than go to work, kids take online
classes rather than go to school. With so
much uncertainty it is almost impossible to
get into a rhythm. All of this leads to
boredom and depression [36].
3. Feeling socially isolated: Psychologists
note the difference between living alone
and loneliness. Some people live alone and
have no family, and they usually don’t
think much about it. But, as the new virus
forces them to socially distance, they start
feeling lonely. They miss the ability to see,
chat, hug, or spend time with friends. Life
seems shallower, more like survival than
living, especially if they live alone [39].
4. Anger, frustration or irritability: This
trio of feelings has its root in the fact that
people have to control so many things at
once and to respond to so many
emergencies as previously mentioned. All
this pressure they are facing will be
translated into anger, frustration, and
irritability [40].
5. Changes in sleep patterns: There is a
common association between anxiety and
sleep disturbances. During this pandemic,
people get worried about their job security,
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 Coronavirus Pandemic: Coping with the Psychological Outcomes,
Mental Changes, and the “New Normal” During and After COVID-19
DOI: https://doi.org/10.36811/ojda.2020.110005
their savings, and their loved ones. There
are also people who are ‘hooked’ to
COVID-19 news alerts and its ongoing
statistics stream. The stress from thinking
about all this reflects on their sleep quality.
They could either have a problem with
sleep onset or they could have a problem
with sleep maintenance [36,41].
6. Changes in eating habits: As a result of
the coronavirus pandemic people started
questioning their vulnerability and
immunity to disease and illness. They
started re-evaluating their diets and
lifestyles on a daily basis. The coronavirus
pandemic, and its associated lockdowns,
have had a profound impact on their eating
habits. Many of them, locked up in their
homes and unable to visit restaurants,
turned to home cooking and baking,
looking for products with disease
prevention and immunity boosting
ingredients. Conversely, there are those for
whom the opposite is true where they have
reported that in response to the crisis they
are actually eating less healthily. Reasons
for that include more boredom and
temptations at home. They had started
snacking and snacking more, and practicing
binge eating habits [42].
7. Worsening of mental health conditions:
Coronavirus can have a significant impact
on everyone's mental health, but
particularly on those with pre-existing
mental illness. Both the anxiety of
contracting the disease as well as the
increase in loneliness and isolation can
worsen and trigger mental illness
symptoms in those people [36].
8. Increased use of alcohol, tobacco, or
drugs: The impact of COVID-19 has left
many people with feelings of stress,
anxiety, and depression. They may start
using alcohol, tobacco, or drugs as a coping
mechanism and as a temporary relief for
those symptoms [43,44].
9. Avoiding medical care due to fear of
being infected while in care: COVID-19
fears are making people avoid medical care.
Patients are ignoring their symptoms of
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other diseases and dangerously delaying
life-saving treatment over fears that they
may contract the coronavirus in emergency
rooms and hospitals [45]. This mixed bag
of emotions could reflect how affected
people really are, according to experts, the
more severe the isolation, the more severe
the psychological impacts and symptoms.
Prevention and Management of
Psychological and Mental Health
Conditions During COVID-19
Although knowledge is increasingly available
for the medical aspects of the pandemic, there
is little information and guidance for health care
facilities and practitioners about how to handle
the psychological implications of large-scale
disasters such as COVID-19 Pandemic [46].
Nevertheless, the good news is that some
governments have stepped up to address those
mental health stressors. They reported what
should be done by communicating quarantine
guidelines and measures, with an emphasis on
special vulnerable target groups. By addressing
some of these stressors, governments can help
lessen the impact that quarantine can have on
the psychological and mental health of people
facing this pandemic [47,48]. Moreover, the
World Health Organization and the Centers for
Disease Control and Prevention have issued
guidelines to effectively cope with the COVID-
19 outbreak and prevent mental health
problems during this pandemic. The
summarized guidelines are as follows [37,49]:
For General Population [37,49,50]
1. Stick to trustworthy information
sources: Stay informed about the situation
via reliable sources such as the (CDC), the
(WHO), as well as the trusted local public
health authorities.
2. Limit media intake and follow-up: Limit
the news and social media intake to avoid
feeling overwhelmed. Limit how often you
check for updates. Constant monitoring of
news and social media feeds can quickly
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DOI: https://doi.org/10.36811/ojda.2020.110005
turn compulsive and counterproductive
fueling anxiety rather than easing it.
3. Create a daily routine: Make a to-do list
of all the things you want to achieve each
day to create a sense of normality and
productivity.
4. Take care of your body: Eat healthy well-
balanced meals, get plenty of sleep, and
exercise daily. That could include
conducting indoor workout classes,
stretching or practicing meditation.
5. Consume less coffee: Less coffee can be
better for the naturally anxious and
occasionally uncontrollable personalities.
Move onto more water at some point. Keep
your focus once you’re awake and working
at a pace that suites you.
6. Stay connected: Stay in touch with
colleagues, friends and family via phone
calls, texts, social media and video
conferencing. Social distancing is not easy.
Keep communicating with the outside
world as much as you can.
7. Prepare a stock of medical supplies:
Prepare at least a 30-day supply of
prescription medications. Also, worth
having are over-the-counter pain relievers,
antacids, cough and cold medicines, and
vitamins where necessary. It is advisable to
ask your doctor for extended prescription
supplies to cover you over the quarantine
period.
8. Avoid burnout: Set strict limits to your
work from home to avoid becoming
overwhelmed and make time to unwind.
9. Try something new: While many of us
may be reluctant to break away from what
we already know and enjoy, quarantine
time is an ideal time to try some new things.
Many of us will try to learn new valuable
skills as we engage in self-entertainment. It
might be reading, writing, painting,
drawing, knitting, music learning, or a
million other things. Whatever you enjoy
and makes you happy is the right answer
here.
10. Take one day at a time: Try not to project
too far into the future. It is a difficult period
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and it will pass. Remember that these are
temporary measures and you are not alone.
For Parents [51]
1. Talk to your child or teen about the
COVID-19 outbreak. Answer questions
and share facts about COVID-19 in a way
that your child or teen can understand.
2. Reassure your child or teen that they are
safe. Let them know it is ok if they feel
upset.
3. Deal with your own stress so that they can
learn from you how to cope.
4. Limit your family’s exposure to news
coverage including social media. Children
may misinterpret what they see and hear
and can be frightened about something they
do not understand.
5. Try to keep up with regular routines. If
schools are closed and there is no online
learning, create a schedule for learning or
fun activities. Connect with your friends
and family members and advice your child
or teen to connect with their friends and
family members as well.
6. Be a role model so that your children can
feel at ease. Children and teens react partly
on what they see from adults around them.
When parents and caregivers deal swith the
COVID-19 calmly and confidently, they
can provide the best support for their
children.
For People with Pre-existing Psychological
and Mental problems [52-55]
1. Continue with your treatment and be aware
of any new or worsening symptoms.
2. Immediately consult your doctor whenever
you feel psychologically or mentally
deteriorated.
For Healthcare Workers [56,57]
1. Remember your mission: Always
remember why you chose this path.
Remember that despite the present
challenges and frustrations, your mission is
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a noble one: taking care of those in need at
a time of great uncertainty. Remember the
importance and meaning of your work.
2. Build your resilience: Build resilience
through any method, whether physical,
psychological, or spiritual to help you face
hard times. Resilience helps you bounce
back from stressful situations. It helps you
view difficulties as challenges and become
proactive in your response. Resilience is a
feature which can be learnt through
practice.
3. Focus on the present: Whatever you are
going through shall end, and focusing on
the present will give you the opportunity to
become your best self. Try not to think
about the following weeks or months to
come. Focus on doing the best you can with
whatever means you have now. Don’t stress
about things that are out of your control.
4. Be realistic but stay positive: It is easy to
lose yourself in negative thoughts.
Anticipate upcoming problems, but don’t
let them turn you down. Remember the
patients you helped to recover and those
you helped to comfort in the most difficult
times.
5. Take breaks from the news and social
media: Step away from your computer and
smart phone from time to time. When
returning online, focus on information from
trustful sources, not just sources in your
social media feed. You don’t have to take
in everything produced by a 24/7 news
cycle.
6. Practice self-care: Take care of yourself,
eat healthy food, stay active, exercise
regularly, and rest between shifts. De-stress
in healthy ways and avoid smoking or
drugs. When being at home, shut off any
thoughts related to your work, watch a
movie or listen to calm music, connect with
your loved ones even if it is only through
video-calls.
7. Perform regular check-ups for yourself:
Screen yourself for symptoms of
depression or stress such as prolonged
sadness, extreme fatigue, sleeping
difficulties, exaggerated emotional
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responses, intrusive memories and/or
feelings of hopelessness. If symptoms
persist or worsen over time, talk to a trusted
colleague or seek professional help.
For Managers and Team Leaders in
Healthcare Facilities [58,59]
1. Take care of your staff: Protect your staff
from chronic stress and poor mental health
as much as you can, so that they can support
patients and because it is the right thing to
do.
2. Create an environment of open
communication: Encourage staff to
discuss their concerns openly, ask
questions, and support each other. Provide
brief regular forums to update staff on the
practice status and how management is
addressing challenges.
3. Adjust staffing procedures and
schedules (where possible): Rotate
workers from higher-stress to lower-stress
functions. Partner inexperienced workers
with more experienced colleagues, who can
provide support, monitor stress, and
reinforce safety practices. Implement
flexible schedules for workers who are
directly affected or have a family member
affected by the outbreak.
4. Offer access to psychological and mental
support: Provide access to psychological
and mental support sources for staff
responding to the outbreak, making this as
much of a priority as ensuring their physical
safety.
For Older Adults [60,61]
1. Ensure you have enough medication
doses: If you need a repeat prescription,
call your family physician. Allow someone
else to pick up the prescription and
medication, even if you feel fine and have
always done this yourself. Organizations
recommend having additional drugs on
hand for quarantine situations. 30-day
supplies are typical and often advised.
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2. Continue taking your regular
medication: It is important for anyone who
has to take regular medication to continue
with this, especially if you have chronic
conditions or other illnesses that requires
that.
3. Eat healthy food and never skip meals:
Changes in the type of food eaten due to
changes in food availability during
lockdowns may precipitate the
exacerbation of chronic illnesses in elderly
adults. Therefore, eating healthy food and
never skipping meals is highly advisable.
4. Learn and perform simple daily
exercises to practice at home: Lack of
exercise and movement during lockdown
may lead to deconditioning and body
deterioration with subsequent weakness
and falls. Performing daily exercises and
simple movements is recommended.
5. Know in advance where and how to get
practical help: Early identification of any
health issue may help prevent
hospitalization. Where appropriate, do not
hesitate to accept available home care
services, which may be essential to
preserve your health during COVID-19.
6. Keep regular schedules and keep in
touch with loved ones: As much as
possible, keeping regular phone calls or
video conferencing with friends, family,
and caregivers can be very helpful during
lockdown periods.
7. Sleep and maintain circadian rhythms:
Sleep is critically important to cognitive
functioning and the immune system. One of
the simplest recommendations that can be
given to older adults to help prevent disease
transmission and mitigate anxiety is to
sleep well.
For People in Isolation [62]
1. Stay connected and maintain your social
network: Try to keep your daily personal
routines as much as possible, or create new
routines if you can. Stay in touch via phone,
e-mail, social media or video conference.
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2. Pay attention to your own needs and
feelings: Engage in healthy activities that
you enjoy and find relaxing. Exercise
regularly, maintain regular sleep routines
and eat healthy food.
3. Stay away from too much news which
can create negativity: A continuous
stream of news reports about an outbreak
can cause anxiety or distress to anyone.
Seek information updates and practical
guidance only during the day and at specific
times and avoid listening to or following
rumors that make you feel uncomfortable.
Long-Term Consequences of COVID-19
Pandemic on Psychological and Mental
Health
Even for those who weren’t directly affected by
COVID-19, the pandemic has been a significant
stressor on everyone’s life. People may have a
strong emotional reaction which may last for
decades after the pandemic recedes [63].
Deterioration of social networks and
economies, stigma towards survivors of
COVID-19, increased anger and aggression of
frontline workers, possible mistrust of
information provided by official authorities, are
some of the long term consequences of
COVID-19 predicted by the Inter-Agency
Standing Committee on Mental Health and
Psychological Support (IASC). [64]. Those
who struggle with other mental health
conditions, such as anxiety or depression, or
who have a previous history of trauma, may be
at increased risk of long-term distress.
Similarly, healthcare workers providing
frontline services, as well as people who have
lost their loved ones or jobs due to the disease
may be at higher risk of developing long-term
problems [65]. Some of these consequences
could be due to realistic dangers, but many
could be due to lack of knowledge, rumors and
misinformation. On the other hand, some
people may have positive experiences, such as
pride about finding ways of coping with this
pandemic [66].
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The “New Normal” After the COVID-19
Outbreak
COVID -19 crisis is different from any other
crisis. It’s like being diagnosed with cancer.
The year or years that follow the lifting of stay-
at-home orders won’t be true recovery, but
something better understood as “adaptive
recovery” or as the “New Normal”, in which we
learn to live with the virus even as we look
forward to medical progress in eradicating it.
Life during COVID-19 and after it is the “New
Normal” There is no returning to memories of
what was before [67]. Meanwhile, during our
“New Normal”, we will need to continue
monitoring and testing for COVID -19,
applying a vigorous public health approach to
slow down the virus spread by isolating,
treating, contact tracking, and taking
appropriate measures, to physically distance
ourselves from others [68]. After this crisis
ends, what does our “New Normal” look like?
How are we going to reinvent ourselves? How
optimistic or pessimistic shall we be? There is
a spectrum of possible post-coronavirus
futures, no straight line from here to there.
Futurists have begun to imagine the post-
coronavirus era. It is rather the beginning of a
“New Normal” for all of us. A way that
minimizes the risks of COVID -19 but allows
us to earn our living, educate our children and
keep our healthcare systems functioning. Below
are some of the “New Normals” where COVID-
19 is predicted to change our lives in the near
future and beyond [67,69,70]:
1. A “New Normal” when restrictions on
social distancing are lifted. Many people
will not grasp that this is not over. Despite
the "happy talk," people will not emerge
suddenly immune from the lockdown. The
vast majority will remain susceptible to the
virus. The virus will spread. It will keep
hitting the population. Mostly everyone
will be exposed over the next year until 60
to 70 percent of herd immunity is achieved.
2. A “New Normal” where we lock down the
lockdown. The changes will become
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permanent until someone wins the billion-
dollar prize for a vaccine. The cost will be
loss of schools, economic hardship, mass
unemployment, psychological pain,
shattered marriages. A crisis as big as the
"Great Depression".
3. A “New Normal” of alternation between
easing of restrictions to turn the economy
back and between permanent lockdown
again when new outbreaks occur. This
cycle will alternate until herd immunity
increases and physical distancing no longer
becomes necessary.
4. A “New Normal” where the world will
trend towards working at home, shopping
at home, conferencing from home, and
maybe even virtually travelling to other
cities from home. There will be a trend to
make one’s home self-sufficient. This trend
could lead to more recluses, more shut-ins,
and more people who create cocoons in
their homes or apartments to protect
themselves from germs in the outside
world.
5. A “New Normal” where fear of infection
could make people more weary, more
anxious, more germaphobic about trains,
planes and shared cars. Masks will become
a wardrobe priority. No kisses, no high-
fives, no handshakes. We are going to move
into a world where every 'contact' will have
to be scheduled on Zoom, or managed in a
non-spontaneous manner, keeping
distance, observing rules, and checking on
others if they are following them too.
6. A “New Normal” where there will be
cleaner and safer job sites. The virus has
made everyone aware of the importance of
health and safety. Companies will respond
by implementing new job site policies such
as alternating shifts, temperature checks for
employees and top-to-bottom disinfections.
Managers and supervisors will promote
social distancing and health regulations for
employees, including a carpooling ban, a
100% mask and glove policy, and well-
stocked handwashing stations. Employers
will no longer be doing business in the
same way they have done in the past. They
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will need to be flexible and creative as they
will need to think about new ways to
perform certain tasks.
7. A “New Normal” for projects’ timelines.
Projects will take longer. Many of the
major workplace safety changes will add to
the time it takes to complete projects. While
crucial to keep employees healthy,
techniques such as keeping up with PPE,
allowing only a limited number of
employees on a site at the same time and
alternating work shifts will slow down
progress of projects, and the days of fast-
tracking a project may be over - at least for
a long period of time.
8. A “New Normal” will be teleworking. The
coronavirus will bring major changes to
office work. Forced to stay at home, many
office employees will keep business
operations running via remote work,
relying on technology like
videoconferencing, emailing and texting to
stay in touch. This nationwide tele working
experiment will likely cause many leaders
to think about making the practice
permanent. Companies will move most of
their office workforce to permanently
remote positions. While the trend toward
remote work will lead to a dramatic
reduction in the need for office space for
many companies, others might think about
expanding. These firms may seek to take
advantage of lower rents in order to expand
their office space allowing for greater
social distancing in the workplace. This
could mean a moving away from the
popular open office space layouts to allow
for additional private spaces.
Conclusion
The psychological impact of this quarantine is
wide-ranging, substantial, and long lasting. It
has caused tremendous psychological problems
in different subpopulations. Despite that
authorities have announced relevant policies
and guidelines in a strategic manner, the
COVID-19 outbreak has posted an emerging
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OJDA: June-2020: Page No: 07-19
serious challenge for the psychological and
mental health worldwide. With the disruptive
effects of this pandemic, it is important that we
stay mindful and sensitive to our mental health
needs and to that of the ones we care for. Our
anxiety and fears should be acknowledged and
not ignored, but better understood and
addressed by individuals, communities and
governments. The issue facing each and every
one of us is how we manage and react to the
stressful situation unfolding so rapidly in our
lives and communities. The further we look into
the future, the more we can imagine how global
society may well be reinvented by this
pandemic. The experience from this public
health emergency should guide governments
and authorities how to efficiently intervene in
any future crisis around the world.
References
1. Yang X, Yu Y, Xu J, et al. 2020. Clinical course
and outcomes of critically ill patients with
SARS-CoV-2 pneumonia in Wuhan, China: a
single-centered, retrospective, observational
study. Lancet Respir Med. Ref.:
https://bit.ly/2WHtNSE
2. COVID-19 pandemic. United Nations
Development Programme. 2020. Ref.:
https://bit.ly/2LEHWKf
3. Director-General's remarks at the media
briefing on 2019-nCoV on 11 February 2020.
World Health Organization. Ref.:
https://bit.ly/3dZAAwK
4. Sohrabi C, Alsafi Z, O'Neill N, et al. 2020.
World Health Organization declares global
emergency: A review of the 2019 novel
coronavirus (COVID-19). 76: 71-76. Ref.:
https://bit.ly/2zM1WYG
5. Q&A on coronaviruses. World Health
Organization. 11 February 2020. Retrieved 13
April 2020.
6. How COVID-19 Spreads. Centers for Disease
Control and Prevention (CDC). 2 April 2020.
7. Q & A on COVID-19. European Centre for
Disease Prevention and Control. Retrieved 30
April 2020.
Page: 16
 Coronavirus Pandemic: Coping with the Psychological Outcomes,
Mental Changes, and the “New Normal” During and After COVID-19
DOI: https://doi.org/10.36811/ojda.2020.110005
8. Coronavirus Disease 2019 (COVID-19) -
Environmental Cleaning and Disinfection
Recommendations. Centers for Disease Control
and Prevention. 11 February 2020. Retrieved 24
March 2020.
9. Coronavirus disease (COVID-19) advice for
the public: When and how to use masks. World
Health Organization. Retrieved 9 March 2020.
10. Feng S, Shen C, Xia N, et al. 2020. Rational use
of face masks in the COVID-19 pandemic.
Lancet Respir Med. 8: 434-436. Ref.:
https://bit.ly/2ZgYbVO
11. Considerations relating to social distancing
measures in response to COVID-19- second
update. European Centre for Disease
Prevention and Control. 24 March 2020.
12. A List of What's Been Canceled Because of the
Coronavirus. The New York Times. 1 April
2020. Retrieved 11 April 2020.
13. Infection prevention and control during health
care when novel coronavirus (nCoV) infection
is suspected (interim Guidance). World Health
Organization. January 2020.
14. Bao Y, Sun Y, Meng S, et al. 2020. 2019-nCoV
epidemic: address mental health care to
empower society. 395: 37-38. Ref.:
https://bit.ly/2TiJFch
15. Shigemura J, Ursano RJ, Morganstein JC, et al.
2020. Public responses to the novel 2019
coronavirus (2019-nCoV) in Japan: Mental
health consequences and target populations.
Psychiatry Clin Neurosci. 74: 281-282. Ref.:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C7168047/
16. Mian A, Khan S, 2020. Coronavirus: the spread
of misinformation. BMC Med. 18: 89. Ref.:
https://bit.ly/3bQoaWQ
17. Cuan-Baltazar JY, Muñoz-Perez MJ, Robledo-
Vega, et al. 2020. Misinformation of COVID-
19 on the Internet: Infodemiology Study. JMIR
Public Health Surveill. 6: 18444. Ref.:
https://bit.ly/2LEAEWJ
18. Brooks SK, Webster RK, Smith LE, et al. 2020.
The psychological impact of quarantine and
how to reduce it: rapid review of the evidence.
Lancet. 395: 912-920. Ref.:
https://bit.ly/2WIReuP
19. Wilder-Smith A, Freedman DO. 2020.
Isolation, quarantine, social distancing and
www.raftpubs.com
OJDA: June-2020: Page No: 07-19
community containment: pivotal role for old-
style public health measures in the novel
coronavirus (2019-nCoV) outbreak. J Travel
Med. 27. Ref.: https://bit.ly/2LFeWll
20. Nicola M, Alsafi Z, Sohrabi C, et al. 2020. The
Socio-Economic Implications of the
Coronavirus and COVID-19 Pandemic: A
Review. Int J Surg. Ref.: https://bit.ly/3bLGlNg
21. Qian X, Ren R, Wang Y, et al. 2020. Fighting
against the common enemy of COVID-19: a
practice of building a community with a shared
future for mankind. Infect Dis Poverty. 9: 34.
Ref.: https://bit.ly/2AzSyHM
22. Onyeaka HK, Zahid S, Patel RS. 2020. The
Unaddressed Behavioral Health Aspect During
the Coronavirus Pandemic. Cureus. 12: 7351.
Ref.:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C7170020/
23. Wang C, Pan R, Wan X , et al. 2020. Immediate
Psychological Responses and Associated
Factors during the Initial Stage of the 2019
Coronavirus Disease (COVID-19) Epidemic
among the General Population in China. Int J
Environ Res Public Health. 17. Ref.:
https://bit.ly/2LGCvKB
24. Li S, Wang Y, Xue J, et al. 2020. The Impact of
COVID-19 Epidemic Declaration on
Psychological Consequences: A Study on
Active Weibo Users. Int J Environ Res Public
Health. 17. Ref.: https://bit.ly/3cMlFpz
25. Choo EK, Rajkumar SV. 2020. Medication
Shortages During the COVID-19 Crisis: What
We Must Do. Mayo Clin Proc. Ref.:
https://mayocl.in/2LCAxuV
26. Inter-Agency Standing Committee Guidelines
on Mental Health and Psychosocial support.
MH Innovation. 28 March 2020.
27. Pfefferbaum B, North CS. 2020. Mental Health
and the Covid-19 Pandemic. N Engl J Med.
Ref.: https://bit.ly/3bHMSIQ
28. Groups at Higher Risk for Severe Illness.
Centers for Disease Control and Prevention
(CDC). April 17, 2020.
29. Hao F, Tan W, Jiang L, et al. 2020. Do
psychiatric patients experience more
psychiatric symptoms during COVID-19
pandemic and lockdown? A case-control study
with service and research implications for
Page: 17
 Coronavirus Pandemic: Coping with the Psychological Outcomes,
Mental Changes, and the “New Normal” During and After COVID-19
DOI: https://doi.org/10.36811/ojda.2020.110005
immunopsychiatry. Brain Behav Immun. Ref.:
https://bit.ly/2Tk9Hf6
30. Shah K, Kamrai D, Mekala H, et al. 2020.
Focus on Mental Health During the
Coronavirus (COVID-19) Pandemic: Applying
Learnings from the Past Outbreaks. Cureus. 12:
7405. Ref.:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C7182052/
31. Coronavirus Disease 2019 (COVID-19):
Groups at Higher Risk for Severe Illness.
Centers for Disease Control and Prevention
(CDC). May 12, 2020.
32. Statement-Older people are at highest risk from
COVID-19, but all must act to prevent
community spread. 2020. World Health
Organization (WHO). Ref.:
https://bit.ly/2LGHzi5
33. Chatterjee SS, Barikar CM, Mukherjee A.
2020. Impact of COVID-19 pandemic on pre-
existing mental health problems. Asian J
Psychiatr. 51: 102071. Ref.:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C7165115/
34. ICN COVID-19 Update: New guidance on
mental health and psychosocial support will
help to alleviate effects of stress on hard-
pressed staff. 2020. International Council of
Nurses (ICN).
35. Kang L, Li Y, Hu S, et al. 2020. The mental
health of medical workers in Wuhan, China
dealing with the 2019 novel coronavirus.
Lancet Psychiatry. 7: 14. Ref.:
https://bit.ly/2zc1DGn
36. Common reactions to the coronavirus: Keeping
Your Distance to Stay Safe. American
Psychological Association (APA ). 2020.
37. Coronavirus Disease 2019 (COVID-19).
Centers for Disease Control and Prevention
(CDC) 28 March 2020. Ref.:
https://bit.ly/3bNfX5s
38. van Doremalen N, Bushmaker T, 2020. Aerosol
and Surface Stability of SARS-CoV-2 as
Compared with SARS-CoV-1. N Engl J Med.
382: 1564-1567. Ref.: https://bit.ly/3dWbO0H
39. Klinenberg E. 2016. Social Isolation,
Loneliness, and Living Alone: Identifying the
Risks for Public Health. Am J Public Health.
106: 786-787. Ref.:
www.raftpubs.com
OJDA: June-2020: Page No: 07-19
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C4985072/
40. Hawryluck, L, Gold WL, Robinson S, et al.
2004. SARS control and psychological effects
of quarantine, Toronto, Canada. Emerg Infect
Dis. 10: 1206-1212. Ref.:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C3323345/
41. Holmes EA, O'Connor RC, Perry VH, et al.
2020. Multidisciplinary research priorities for
the COVID-19 pandemic: a call for action for
mental health science. Lancet Psychiatry. Ref.:
https://bit.ly/2zdr5eF
42. Share of people that eat less healthy due to the
coronavirus outbreak in selected European
countries between March and April 2020.
Statista. 2020. Ref.: https://bit.ly/2X8FmRP
43. Rehm J, Kilian C, Ferreira‐Borges C, et al.
2020. Alcohol use in times of the COVID 19:
Implications for monitoring and policy. Drug
Alcohol Rev. Ref.: https://bit.ly/36jR14E
44. The implications of COVID-19 for people who
use drugs (PWUD) and drug service providers".
European Monitoring Centre for Drugs and
Drug Addiction (EMCDDA). 2020.
45. Rajkumar RP. 2020. COVID-19 and mental
health: A review of the existing literature. Asian
J Psychiatr. 52: 102066. Ref.:
https://bit.ly/3cIC7Hy
46. Freeman MP. 2020. COVID-19 From a
Psychiatry Perspective: Meeting the
Challenges. J Clin Psychiatry. 81. Ref.:
https://bit.ly/2WJHC32
47. Starace F. Ferrara M. 2020. COVID-19 disease
emergency operational instructions for Mental
Health Departments issued by the Italian
Society of Epidemiological Psychiatry.
Epidemiol Psychiatr Sci. 29: 116. Ref.:
https://bit.ly/3fW4OTc
48. Jakovljevic M, Bjedov S, Jaksic N, et al. 2020.
COVID-19 Pandemia and Public and Global
Mental Health from the Perspective of Global
Health Securit. Psychiatr Danub. 32: 6-14. Ref.:
https://bit.ly/2LFcift
49. Mental health and psychosocial considerations
during the COVID-19 outbreak". World Health
Organization (WHO). 26 March 2020. Ref.:
https://bit.ly/2WHw3t2
Page: 18
 Coronavirus Pandemic: Coping with the Psychological Outcomes,
Mental Changes, and the “New Normal” During and After COVID-19
DOI: https://doi.org/10.36811/ojda.2020.110005
50. Managing your mental health during the
coronavirus outbreak. Mental Health
UK.March 31, 2020; Ref.:
https://bit.ly/2zaW5fs
51. How to talk to your kids about COVID-19.
Mayo Foundation for Medical Education and
Research (MFMER). 2020. Ref.:
https://mayocl.in/2ZfGtSw
52. Fineberg NA, Van Ameringen M , Drummond
L, et al. How to manage obsessive-compulsive
disorder (OCD) under COVID-19: A clinician's
guide from the International College of
Obsessive Compulsive Spectrum Disorders
(ICOCS) and the Obsessive-Compulsive
Research Network (OCRN) of the European
College of Neuropsychopharmacology".
Comprehensive Psychiatry, 27 April 2020.
Ref.:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C7152877/
53. Rosman K. 2020. For Those With O.C.D., a
Threat That Is Both Heightened and Familiar".
The New York Times.
54. Pyrek E. COVID-19 proving extra challenging
for people with OCD and other mental health
conditions. La Crosse Tribune. 27 April 2020.
55. Moore G. Battling anxiety in the age of
COVID-19. Australian Associated Press. 27
April 2020.
56. Walton M, Murray E, Christian MD. 2020.
Mental health care for medical staff and
affiliated healthcare workers during the
COVID-19 pandemic. Eur Heart J Acute
Cardiovasc Care.Ref.: https://bit.ly/2WI7M6c
57. Zhang WR, Wang K, Yin L, et al. 2020. Mental
Health and Psychosocial Problems of Medical
Health Workers during the COVID-19
Epidemic in China. Psychother Psychosom. 1-
9. Ref.: https://bit.ly/2XoICsH
58. Peiffer-Smadja N, Lucet JC, 2020. Challenges
and issues about organising a hospital to
respond to the COVID-19 outbreak: experience
from a French reference centre. Clin Microbiol
Infect. Ref.: https://bit.ly/2z3xhGi
59. Dehnavieh R, Kalavani K. 2020. Management-
supportive measures for managers of healthcare
organizations during the COVID-19 epidemic.
Infect Control Hosp Epidemiol. 1. Ref.:
https://bit.ly/3e0o6Fo
www.raftpubs.com
View publication stats
OJDA: June-2020: Page No: 07-19
60. Nanda A, Vura N, Gravenstein S. 2020.
COVID-19 in older adults. Aging Clin Exp Res.
Ref.: https://bit.ly/2Zj8pVu
61. Khoury R, Karam G. 2020. Impact of COVID-
19 on mental healthcare of older adults: insights
from Lebanon (Middle East). Int Psychogeriatr.
1-4. Ref.: https://bit.ly/3cK4Njb
62. Patel KP, Patel PA, Vunnam SR, et al. 2020.
Patients with COVID-19: are current isolation
guidelines effective enough? Public Health.
183: 38-39. Ref.:
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C7211713/
63. Mak IW, Chu CM, Pan PC, et al. 2009. Long-
term psychiatric morbidities among SARS
survivors. Gen Hosp Psychiatry. 31: 318-26.
Ref.: https://bit.ly/36j8QRd
64. Addressing mental health and psychosocial
aspects of covid-19 outbreak. Inter-Agency
Standing Committee. February 2020. Ref.:
https://bit.ly/2TjEk4q
65. Vieta E, Perez V, Arango C. 2020. Psychiatry
in the aftermath of COVID-19. Rev Psiquiatr
Salud Ment. Ref.:
https://www.ncbi.nlm.nih.gov/pubmed/323761
31
66. Fiorillo A. Gorwood P. 2020. The
consequences of the COVID-19 pandemic on
mental health and implications for clinical
practice. Eur Psychiatry. 63: 32. Ref.:
https://bit.ly/3bFd8Dy
67. When covid-19 has done with us what will be
the new normal. The Guardian. 18 April 2020.
Ref.: https://bit.ly/3cGaPBs
68. Zeegen EN, Yates AJ, Jevsevar DS. 2020. After
the COVID-19 Pandemic: Returning to
Normalcy or Returning to a New Normal? J
Arthroplasty. Ref.: https://bit.ly/3bE8aqI
69. After the COVID-19 crisis ends, what does our
'new normal' look like? O.Canada. 2020. Ref.:
https://bit.ly/2LHZwNm
70. Bergen P. Infectious disease expert: We're only
in the second inning of the pandemic. Cable
News Network (CNN). 21 April, 2020. Ref.:
https://cnn.it/3bLf2lW
Page: 19